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No rush for MNsure; only 96 have applied so far in Becker County

By Jan. 1, it will be federal law for nearly everyone to have health insurance or be fined.

That’s the stick.

The carrot is that the federal government will help income-eligible people pay for it.

When given the choice to go with a federal health care exchange or create its own, the state of Minnesota opted to create its own exchange. The enrollment period for MNsure has begun, and Becker County Human Services employees are working to help with the changes.

Why Minnesota chose its own exchange

“Primarily because Minnesota has a lot of other programs that other states don’t have,” Becker County Human Services Director Nancy Nelson said is why Minnesota decided to create its own exchange.

“They’ve gotten waivers from the federal government for a lot of their income maintenance programs, and they wanted to continue with those.

“Signing on to the federal exchange would not have allowed them to do that,” she added.

Minnesota has several other health care options, like MinnesotaCare for example, that the state didn’t want to get rid of.

Not only did MNsure provide more opportunities for purchasing health care insurance, it also expanded Medicaid (which is the federal name for Minnesota’s Medical Assistance program) for children and pregnant women.

Nelson said there were some options for expanding various age groups eligible for Medicaid, and Minnesota chose to expand children ages infant to 2 years, pregnant women and children ages 2-18.

“And then they will continue with MinnesotaCare for parents,” she said.

Why the need for insurance options

There are various reasons an individual wouldn’t have insurance. On the MNsure.org website, there are reasons such as small businesses owners who can’t afford insurance, self-employed workers, college students who are no longer under their parents’ plan, a single mother without insurance and it’s not offered through her employer.

The bottom line is that health insurance likely isn’t affordable for them.

“My sons, two out of the three don’t have insurance,” said Sue Kent, supervisor of income maintenance for human services. “They just can’t afford it.”

They are both self-employed and simply can’t afford another monthly bill.

“I think most people are that way. They pay their basics and … Insurance right now is extremely expensive and it’s a high deductible.”

“It’s the working poor,” Nelson said of who MNsure is geared toward.

According to a 2011 Minnesota Department of Health study, 437,000 uninsured Minnesotans could get financial help to pay a portion of their health insurance; 296,000 of those people are working.

Guidelines to qualify; fines for no coverage

The federal poverty guideline is used to determine eligibility for MNsure.

Depending on income and household size, Minnesota residents can be eligible for Medical Assistance, MNsure, MinnesotaCare or tax credits for private coverage.

The income eligibility is also determined by income taxes filed, something that is new for the county, which has always gone off 30-to-60-day income.

And just like car insurance, you can be fined for not having health insurance as of Jan. 1.

In 2014, it will be either $95 or 1 percent of your taxable income, whichever is greater. The following year the fine increases to $325 per adult or 2 percent of taxable income. In 2016, it increases to $695 per adult or 2.5 percent of taxable income. The penalty for a child is half the adult fine.

How the government will track who doesn’t have insurance is through income taxes.

“It’s connected to the IRS system and through your work records,” Nelson said. “It’s connected to a lot of federal records.”

Glitches along the way; getting assistance

Becker County has beefed up staff to help enroll people for Medical Assistance and MNsure. They have all had to have ongoing training to learn the new programs – both the insurance program and the computer software that came with it.

“They have been doing seminars and meetings for a year or more,” Nelson said.

“Administration has been going through it longer than the front line has,” Kent said. “We were getting ‘this is coming, this is coming,’ and two weeks before Oct. 1 (when enrollment began), we were told ‘it’s still coming, we’ll get you trained.’”

With a large statewide program like MNsure, Nelson said glitches are to be expected.

“For this new program, there’s a new computer system, so it’s not just adding on to what we have, it’s a whole new system and it has to connect to the federal system,” Nelson said.

The federal online system has been riddled with problems so far.

“So it’s not surprising that Minnesota has had some bugs in theirs, too,” she added.

She said they have conference calls twice a week with the Department of Human Services to talk about glitches that are being resolved.

Once the glitches are worked out, people can sign-up for MNsure from the comfort of their home instead of having to go to a provider or human services.

“They can determine from their own home what they want to do,” Nelson said of the various health insurance options people can pick from. “If they are eligible for MNsure, then it will automatically come to the county to have that information.”

Mahube-Otwa is one organization that can help people determine what plan is best for them, she added. Listed on the MNsure.org site are also eight other agencies in Becker County that can help.

For those wanting to sign up for Medical Assistance, though, Nelson encourages them to come into human services right away and get the application started, because the county is still processing those the old way, not through the online application.

In anticipation of the MNsure exchange boom, the county hired extra employees to help.

Through a federal program, it was indicated that Becker County would have about 1,200 eligible people signing up for the program.

So far there’s been 96 pending applications, so obviously the rush has not hit in the first couple weeks.

People have until Dec. 15 to enroll for a starting coverage date of Jan. 1, when the federal law goes into effect.

“People need to be patient right now. If they are applying for MNsure, they have until Dec. 15 to enroll and we’re hoping to get some bugs worked out before that time. If they want MA right now, they need to come in and pick up an application,” Nelson said.

“We don’t want people to miss out if they are eligible for MA now.”

And because those guidelines for Medical Assistance have expanded, there are more people in the county eligible.